̽��ֱ�� of Cambridge - Hannah Newton

Heart-Breaking History: Voices of sick children from the past

bjb42 — Wed, 25 Apr 2012 15:40:08 +0000

Life for children during the Tudor and Stuart age has often been depicted as a pretty miserable experience, characterised by disease, physical hardship, and aloof and strict parenting. But Dr Hannah Newton's book, ̽��ֱ��Sick Child in Early Modern England, 1580 - 1720, adds to an emerging view among historians that society at this time was not as unforgiving as we sometimes think.

Her investigation into the little-studied subject of how families responded to children falling ill and dying uncovers evidence for close familial ties, openly emotional fathers, and even the beginnings of specialist children's care among medical practitioners.

Drawing on sources like doctors’ casebooks, and the letters and diaries of parents, it also brings to life often heart-rending stories about parents who had to sit helplessly at their child's bedside, and of children who tried to keep their parents' spirits up even as they struggled for breath.

Newton chose her sombre topic because it provides an unusual level of insight into what life was like at the time, especially for children. She also wanted to understand more about society's attitudes to children, and how doctors and laypeople approached the task of treating them.

"We don't usually hear much about children's lives during the early modern age," Newton said. "When children became sick and died, however, this all changed. Parents often wrote detailed accounts of their child's life and death, desperate to convince themselves and their relatives and friends that the child had gone to heaven."

"They also wrote letters to other family members and medical advisers, which give us a real sense of what it was like to be there, because they recorded exactly what was happening and what the child was saying. Sources like this offer us a very rare opportunity to hear the voices of children speaking to us from the past."

Although childhood sickness has largely been neglected by researchers, in the 16^th and 17^th centuries it was a fact of life. Between a quarter and a third of children at this time died before they were 15. For every 1,000 babies born alive during the same period, between 123 and 154 did not make it past their first birthday.

̽��ֱ��sheer rate of infant mortality alone has led some historians to conclude that parents were to some extent desensitised to the death of children. This has contributed to an overall picture of a society in which parents were often strict and distant figures.

Newton believes that the reality may often have been quite the opposite, however. ̽��ֱ��personal documents of parents who were trying to nurse their dying children, abound in expressions of unimaginable grief. Discovering the death of her little daughter Pegg in 1647, for example, one mother, Mary Verney, recorded: "I am not able to say one word more, but at this time there is not a sadder creature in the world."

̽��ֱ��experience of child sickness also appears to have brought out the close bonds between family members and blurred gender distinctions. Mothers, fathers, aunts, uncles, grandfathers and grandmothers all turn up in the historical record coming to each other's aid.

Perhaps surprisingly for a society which placed such an emphasis on masculine and feminine "roles", the men's behaviour was often as openly emotional as that of the women. One account, of the death of 12-year-old Caleb Vernon from Battersea, records how, when Caleb knew he was dying, he bequeathed his toys to his sisters and then consoled his father, who had burst into tears at the bedside, that he “longed to be with God". He died a few moments later. ̽��ֱ��study also suggests that the affection of parents was often reciprocated passionately by their children.

Children, like their parents, believed that sickness was God's punishment for their sins. For both parties this could be a bittersweet experience. Parents felt desperate guilt as well as grief, and children themselves often reflected on how "naughty" they had been prior to their illness.

Yet there was also the prospect of going to Heaven, where parents and children believed that they would one day be reunited. In the 1670s, six-year-old Jason Whitrow took his mother by the hand, and said ‘Mother, I shall die, oh that you might die with me, that we might go to the Lord together’.

As well as the accounts of families, Newton has studied those of medical practitioners. These range from case notes and full-scale academic treatises to housewives’ recipe books, which at the time often included recipes for medicine.

They reveal evidence for what she terms "Children's Physic"; the first recognition among doctors that children were more than "small adults" and needed specialist care. Though hardly comparable with modern paediatrics, 17^th century medics did regard children as physiologically distinct: their medicines had to be adapted to make them gentler and more pleasant – for example, sugar was added, and the dose was lessened. Doctors and laypeople were producing special remedies for children themselves, and taking age into account when treating their patients.

̽��ֱ��picture of society that emerges is one in which children were, at least some times, treated with respect, compassion and care. "Parents and relatives had a deep-seated desire to look after their offspring, and when faced with the desperate reality of a child falling ill, the niceties of things like gender or manly behaviour perhaps ceased to matter," Newton said. "Investigating how children and their families responded to sickness and death tells us about far more than medicine: it provides a window into the emotional and spiritual lives of people from the past”.

̽��ֱ��launch of ̽��ֱ��Sick Child in Early-Modern England, 1580 – 1720, published by Oxford ̽��ֱ�� Press, will take place on Wednesday, 25 April.

A new study into the grim and frequently heart-breaking history of childhood sickness and death has opened a window on to a surprisingly tender world of close families and devoted parenting in early modern England.

Parents had a deep-seated desire to look after their offspring. Faced with the desperate reality of a child falling ill, the niceties of gender or manly behaviour perhaps ceased to matter.

Hannah Newton

Collection of the Rijksmuseum, Amsterdam.

̽��ֱ��Sick Child

Case notes: How records of illness allow children to speak to us from the past.

It is notoriously difficult to investigate the experience of childhood in the seventeenth century. Children rarely left written records. However, there is one context in which their voices do survive: illness. Acutely aware of the likelihood of death, parents recorded the thoughts, words, and actions of their sick children in detail. ̽��ֱ��resulting evidence provides rare and intimate insights into the lives and deaths of seventeenth-century children. Below, a sample of children’s stories are given; they are taken from parents’ diaries and doctors’ casebooks.

As she climbed into bed one October night in 1625, three-year-old Elizabeth Wallington said to her father, ‘Father, I go abroad tomorrow and bye you a plomee pie’. Her father, Nehemiah, recorded in his diary that ‘these were the last words that I did here my sweete child speeke’, for several hours later ‘the very panges of death seassed upon her’. She ‘continued in great agonies (which was very grievous unto us the beholders)’ for two days, and died at ‘foore a clocke in the morning, being the eleventh day of October’. Elizabeth’s death greatly affected Nehemiah: he was ‘much disstrackted in my mind and could not be comforted’. This man, a carpenter from London, was to lose four of his five children to childhood disease.

At two o’clock in the morning in 1675, twelve-year-old Caleb Vernon from Battersea, sick of consumption, announced, ‘Now I think I shall die’. He bequeathed ‘all his toyes’ and his pet bird to his sisters Nancy and Betty, and told his mother ‘I love your company dearly’. Seeing his father ‘gush into tears’, he pleaded, ‘Father do not weep, but pray for me[:] I long to be with God’. Caleb began to grow breathless, ‘as if choaked with plegm’, and his father, who was ‘in great care for him’, ran downstairs to fetch some medicines ‘for his relief’. Returning quickly, he saw his son ‘thrusting, first, his finger, and then his whole hand in to his mouth’ to clear his throat. Hearing his father coming, Caleb gasped, ‘O Father, what shall I do!’, and then ‘immediately lay back’, uttered ‘God, God’, and died.

One afternoon in the 1630s, fourteen-year-old boy Richard Gilmore vomited ‘black Worms, about an inch and a half long, with six feet, and little red heads’. After vomiting, he ‘was almost dead, but a little time after he revived’. ̽��ֱ��next day, the boy’s father went to see a doctor from Stratford called John Hall, ‘earnestly desiring’ his advice. He brought with him some of the worms ‘wrapped in Paper’, which, upon examination, ‘crept like Earwigs’. ̽��ֱ��boy was so ‘cruelly afflicted’ that ‘he was ready to tear himself to pieces’ to remove the worms. Dr Hall administered a remedy which made the boy vomit seven times, and bring up ‘six Worms’, the like of which the doctor had ‘never beheld or read of’ before. Dr Hall noted in his casebook that these treatments ‘delivered’ the boy of his infestation, so that when he visited him two years later, he ‘told me he had never been troubled with it since’.

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A spoonful of sugar or a bitter blocker?

bjb42 — Mon, 06 Feb 2012 07:00:40 +0000

Doctors and parents know from experience that it can be difficult persuading a child to take medicine. Averse to bitter tastes, young patients often refuse or spit out their medicines. Julie Mennella, a scientist at the Monell Chemical Senses Center in Pennsylvania, has warned that children’s non-compliance is a ‘public health priority’, and in some instances may impede recovery from illness, or even be life-threatening. Help may be at hand, however: scientists at the 241^st National Meeting of the American Chemical Society have launched a new compound that inhibits the tongue’s of perception of bitter tastes, nicknamed the ‘bitter blocker GIV3616’. This sophisticated substance may come to replace Mary Poppins’ method of adding a spoonful of sugar to disguise bitter tastes. Is this really necessary though? History offers some cheaper, though less high-tech alternatives. My research on children’s medicine in the seventeenth century reveals that physicians and parents at this time devised an assortment of imaginative strategies to make medicines ‘grateful & pleasing to the Sick Child, & such as…trouble not its Pallate’.

It is a common misconception that children’s preference for sweet over bitter flavours is a modern phenomenon, a consequence of the targeted marketing of sugary foods and drinks at the young. Recently, however, scientists have asserted that children’s predilections are ‘a reflection of their basic biology’, evolved for their survival. Specialised taste cells – the taste buds – appear in the fetus at 7 weeks gestation. Within hours of birth, infants reject bitter tastes and prefer sweet ones, according to Mennella. ̽��ֱ��reason is simple: bitterness, like pain, is nature’s warning, a sign of the potential harm that might ensue if the substance is ingested. Sweet foods, on the other hand, are usually safe, and they tend to be rich sources of energy for the growing child. Children’s tastes seem to have changed little over the centuries. ̽��ֱ��Sussex doctor John Pechey wrote in 1697, ‘sweet things which Children eat, and are delighted with…[they] eat greedily’, while a physician from Kent, Robert Pemell, noted in 1653 that children ‘will hardly take’ anything that is ‘so bitter’. These doctors attributed children’s penchants to the heightened sensitivity of the ‘teats’ of their tongues – the taste buds.

One popular seventeenth-century method for making medicines palatable was to substitute unpleasant ingredients with substances of a more agreeable flavour. When treating children for threadworms, Dr Pemell advised giving children ‘juyce of Lemons or Citrons’ in place of the bitter herb wormwood. Where the use of disagreeable ingredients was unavoidable, practitioners tried to disguise the taste by putting the medicine into the child’s normal food or drink. ̽��ֱ��Dutch physician Franciscus Sylvius declared, ‘Knowing that children are nice [fussy], and can scarce be prevailed with to take even the smallest . . . doses’ of bitter medicines, he suggested that ‘these may be given in their milk or drink, they may be [the] better beguiled; scarce discerning them’. Medicines could be mixed with mashed apple, or in the case of babies, breast milk. In addition to disguising the noxious taste, practitioners suggested giving pleasant drinks after the child had taken the medicine, to counter any lingering bad taste. In the 1680s, Thomas Davies fed his child ‘a little beere posset drink…to take away the ill taste’ of a remedy containing castor oil and piony. This adaptation might raise eyebrows today, but weak beer was a standard drink for children in the seventeenth century.

Another way to make medicine tasty was to ‘give it sweetned with Sugar’. ̽��ֱ��historian Joan Thirsk has shown that although honey was the ‘traditional sweetener’, by the 1650s, sugar was becoming more fashionable, because it was regarded as a healthier food. In 1651, the physician Francis Glisson advised adding ‘some pleasant and agreable Liquor, or . . . candid Cherries’ to his medicine on the grounds that the child ‘delights . . . in such things’. Laypeople also sweetened children’s medicines. In 1660, Abigail Harley gave her young niece ‘a drink of maidenhaire & violet leaves & hyslop’ which she had ‘swetened . . . with syrop of violets & sugar candy’. As well as seeking to improve the taste, some parents sought to ameliorate the smell. Sarah Hughes’ recipe for ‘A purge for Children’, dated 1637, had to be tempered with ‘soe much of cinnamon water as will mend the smell’.

Practitioners tried to overcome problems of taste by using distraction. ̽��ֱ��French midwifery expert François Mauriceau suggested that infants suffering from painful teething should be given ‘a Silver Coral, furnish’d with small Bells, to divert the Child’. When it came to treating older children, parents and doctors used a mixture of reasoned argument and praise to persuade young patients to take their medicines. In 1733, the MP John Campbell wrote to his six-year-old son Pryce to commend him for ‘being so good in takeing what the Dr order’d you’. He added, ‘now you see it has done you so much good I hope you will never be unwilling to take what is thought necessary to make you well’. Parents in this period had high expectations of their children, believing them capable of understanding the necessity of taking an unpleasant treatment. Parents also applied emotional or moral pressure: the father of six-year-old Joseph Scholding from Suffolk told his son, ‘If you love me, take it’, to which, the boy responded, ‘to satisfy you, I will take it’. Occasionally, bribery was used. In 1726, John Yorke from London complained that his nephew James ‘is . . . so refractory [about] taking what is proper for him’, that ‘[it is] a hard taske to govern him’. Yorke had to ‘use all my perwasion’ to get the child ‘to take what the Dr order’d’; in particular, he ‘wou[l]d by no means submit to a glister [enema] to cool his body’. Eventually, through promising James a copy of Robinson Crusoe, the uncle managed to coax his nephew into taking the medicine.

While the actual medicines themselves may not have been very effective in the seventeenth century, the desire of doctors and laypeople to make children’s medicines pleasant is something that should be emulated – medicine in the past was not as barbaric as has often been portrayed. Without the sophisticated technology of the present day, practitioners in the seventeenth century used a combination of common sense and compassion when it came to treating children. Adding sugar may be harmful to children’s teeth, but it certainly seems to ‘please and comfort’ the sick child, as one seventeenth-century doctor put it. There may be some extra benefits to sweetening children’s medicines: certain recent investigations show that sugar acts as a form of pain relief in infants, and may even improve the efficacy of antibiotics. Finally, what emerges most strikingly from this discussion, is that human perceptions of taste do not seem to have undergone much change – our love and loathing for sweet and bitter tastes seem to be unaffected by the passage of time.

Dr Hannah Newton, an historian of science with an interest in how previous generations coped with childhood illness, digs up some 17th century tips for making medicine taste better and finds evidence for common sense and compassion among the doctors of the day.

Hannah Newton

Hannah Newton.

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